A growing understanding of the multiple genetic and environmental pathways that contribute to the development of cancer is leading to the concept of a personalized approach to cancer therapy and prevention. This requires techniques to characterize patient and tumor factors that will drive specific targeted interventions and measure their effectiveness. Biomedical imaging now offers the opportunity to characterize tumor anatomy, physiology, and molecular biology in unprecedented ways. The challenge is to harness this technology to develop quantitative approaches to diagnosis that will support the development and application of targeted treatments and preventive interventions. Since its inception, ACRIN has developed and implemented multicenter clinical trials to establish the effectiveness of imaging in the detection, characterization and monitoring of cancer. Working with its biostatistics center at Brown University, ACRIN has assembled a unique organization of hundreds of clinical imaging specialists, other clinicians, and non-physician researchers at more than a hundred institutions nationally and internationally working collaboratively with the broader cancer research community dedicated to cancer imaging research. Over the next grant cycle, ACRIN proposes 3 major scientific objective related to the theme of personalized cancer care: 1. targeted surveillance of at-risk populations;2.characterization of cancer in order to drive targeted therapy;and 3. development of imaging-based predictive and prognostic biomarkers of response to targeted treatment. Through its continued leadership in the imaging community, ACRIN will play a pivotal role in the advancement of cancer detection and therapy. ACRIN will work to discover ways for imaging to improve cancer care. This includes determining the optimal methods to detect cancer early in order to provide the best opportunity for cure, and establishing techniques to characterize cancer and its response to treatment in order to choose the most appropriate therapy.